JCPSLP Vol 19 No 1 March 2017

Table 3. Potential strategies to facilitate Aboriginal families’ engagement with SLP services

Theme

Subtheme

Possible strategies

Client and caregiver

Awareness of service

Hold community education sessions Encourage clients to share their positive SLP experiences with family and community Hold drop-in clinics in familiar locations (e.g., Aboriginal Medical Service)

Inform caregivers that improvements in a child’s communication can lead to improvements in behaviour, confidence, and education Encourage caregivers to seek feedback from stakeholders (e.g. preschool) about improvements in their child’s communication Hold a separate session before assessment, to gather case history from caregiver Enforce positives that caregivers are doing (e.g., bringing their child to the appointment), and things that they have picked up on (e.g., practising speech sounds at home) Inform caregivers: • What SLP services entail (e.g., assessment followed by therapy) • That therapy will be practical, relevant and enjoyable • About strategies they will learn for themselves to use with their children at home • About expectations and requirements of therapy, (e.g., number of sessions, homework) • That personal and health questions will be asked

Changes to child’s communication

Expectations of service

Location and physical access

Identify site that is most easily accessible for public transport

Impact of the health service (individual clinician and organisational factors)

Flexibility

Talk to caregivers about what would be a good time for them to attend (e.g., fitting in with other commitments) and arrange appointments at these times Spend the first session getting to know the family Maintain same clinician throughout service provision (if not possible conduct a handover appointment where new speech-language pathologist attends session)

Relationship

Community and Aboriginal culture

Aboriginal culture Treat each caregiver as an individual

Ensure Aboriginal-specific SLP resources (e.g., dolls, books) are available Consider including Aboriginal languages in therapy Aboriginal staff to support clinical staff to engage with Aboriginal families

Expectations of service Participants spoke about their experiences with SLP services, expressing some uncertainties initially about what therapy would entail: It was a lot different to what I expected. I was expecting it to be, not exactly boring, but not as enthusiastic as it is. (8) They [other Aboriginal people] probably don’t get to experience what speech therapy is like. So many questions are asked in the first appointment. (10) Commitment of caregiver One theme that emerged strongly was that of caregiver commitment and motivation. A number of participants emphasised their commitment to their children’s care, and wanting the best outcomes for their children: “We both put ourselves on the backburner and do everything we can for It was important for caregivers that their children liked the speech-language pathologist: “He’s excited to go there” (2). Child’s receipt of attention It was also important for caregivers that their children received individual attention: “The work is directed especially at her, as her own person, and L loves the individual attention she gets from [the speech-language pathologist]” (3). the kids” (3); “It’s going to improve his future” (2). Child and caregiver experience with speech therapy

Caregiver skill acquisition Caregivers also reported the benefits of learning new skills themselves: “It’s shown me how I can do different sounds with my son” (8); “We play the games at home and we both enjoy them” (3). Theme 2: Impact of the health service (individual clinician and organisational factors) The participants mostly spoke about their experiences with the SLP service, but also made comments relating to Aboriginal-specific health services they had attended. Flexibility Some participants identified that the service flexibility facilitated them to attend SLP: “It’s been pretty good working around our schedule. I don’t work Fridays, so we appointment was seen as positive by participants: “I’m able to take my baby as well and [ speech-language pathologist ] doesn’t mind” (5). Relationship Positive aspects of the relationship between the speech- language pathologist and both the caregivers, and the child, were directly referenced by many: “[The speech- language pathologist] is friendly and welcoming” (3); “Seeing the same person and having continuity of care. I feel comfortable” (4). can normally get an appointment on Fridays” (1). Being able to bring siblings to their child’s SLP

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JCPSLP Volume 19, Number 1 2017

Journal of Clinical Practice in Speech-Language Pathology